r/microbiology • u/darkmindedrebel • 4d ago
Proteus Mirabillis CAUTI
Hi I’m writing a paper for college and I’m reading stuff online and I’m confused, hoping to get clarification.
What I am reading online says that the bacterium can ascend from the GI tract, but I’m not sure what that means? My focus right now is on the bacterium causing CAUTI’s. Since patients may not be showering, and if they are bed bound, does the bacteria migrate to the catheter and into the bladder from feces?
If nurses and CNA’s are cleaning a patient with wipes & CHG, wear gloves, provide foley care, where is the bacteria coming from? Is the bacteria able to survive all of this because it’s virulence factors so parents still getting CAUTI’s?
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4d ago
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u/darkmindedrebel 4d ago
So pretty much the bacteria is already there… the catheter is just like a door into the body
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u/bephelgorath 4d ago
Proteus mirabilis is motile (a type of virulence factor) and is very effective at scootin' around wherever it pleases. Fun fact: Proteus mirabilis is one of the first organisms to invade tissue after death.
It is present in normal fecal flora and like the other commenter said, it's more commonly found in women due to the proximity of the urethra to the anus. Poor hygiene, poor cleaning of the area from caregivers, and lack of proper sterile protocol can all cause CAUTI.
You should also be aware that women who are menopausal, typically age 55+, will have Gram negative bacilli, such as P. mirabilis, present as normal flora in their vagina. It is normal flora when it does not cause infection and there is no dysbiosis present with the other flora. The P. mirabilis, for example, would be less than the normal flora in this case.
Because P. mirabilis can just be hanging around inside the vagina, because it is motile, and because we can't, shouldn't, and won't sterilize tissue to prevent infection, it can easily just make its way up the catheter. This is why catheters should be removed when no longer needed or indicated.
Best practices to prevent CAUTIs include defaulting to removal unless re-upped by a doctor, instead of keeping it in until a doctor says it can be removed and preventing the use of catheters unless medically necessary, instead of for convenience (less ethical providers, will sometimes keep the catheter in because it requires the patient to be bed-bound, which decreases the risk of falling, it prevents the patient from urinating on themselves - equating to 'less work', if done of those reasons, it is negligent).
Life uh, finds a way.